Original research
Concurrent validity of the ActiGraph GT3X+ and activPAL for assessing sedentary behaviour in 2–3-year-old children under free-living conditions

https://doi.org/10.1016/j.jsams.2019.08.009Get rights and content

Abstract

Objectives

ActiGraph accelerometer cut-points are commonly used to classify sedentary behaviour (SB) in young children. However, they vary from 5counts/5 s to 301counts/15 s, resulting in different estimates and inconsistent findings. The aim was to examine the concurrent validity of ActiGraph GT3X + cut-points against the activPAL for measuring SB in 2–3-year-olds during free-living conditions.

Design

Observational validation-study.

Methods

Sixty children were fitted with the activPAL and ActiGraph simultaneously for at least 2 h. Nine ActiGraph cut-points ranging from 60 to 1488 counts per minute were used to derive SB. Bland & Altman plots and equivalent tests were performed to assess agreement between methods.

Results

Estimates of SB according to the different ActiGraph cut-points were not within the activPAL ±10% equivalent interval (-4.05; 4.05%). The ActiGraph cut-points that showed the lower bias were 48counts/15 s (equivalence lower limit: p =  0.597; equivalence upper limit: p < 0.001; bias: -4.46%; limits of agreement [LoA]: -21.07 to 30.00%) and 5counts/5s (equivalence lower limit: p < 0.001; equivalence upper limit: p =  0.737; bias: -5.11%; LoA: 30.43 to 20.20%). For the 25counts/15s, 37counts/15s and 48counts/15s ActiGraph cut-points, the upper limits were within the equivalent interval (p < 0.001) but not the lower limits (p > 0.05). When using the 5counts/5s and 181counts/15s ActiGraph cut-points, lower limits were within the equivalent interval (p < 0.001) but not the upper limits (p > 0.05). Confidence intervals of the remaining ActiGraph cut-points lie outside the equivalent interval.

Conclusions

Although none of the ActiGraph cut-points provided estimates of SB that were equivalent to activPAL; estimates from 48counts/15 s and 5counts/5 s displayed the smallest mean bias (˜5%).

Section snippets

Practical implications

  • The estimation of SB using ActiGraph cut-points may still include a significant error when compared to activPAL estimations in 2–3-year-olds.

  • Estimates of SB calculated with 48 counts/15 s or 5counts/5 s cut-points are the most similar with the estimates provided by activPAL in 2–3-year-olds.

  • In 2–3-year-olds, use other ActiGraph cut-points than 48 counts/15 s or 5counts/5 s to compare estimates of SB provided by actiPAL should be avoided.

Methods

Participant data were collected as part of the Get-Up! Study.21 Data for the present report was gathered at follow up (2017) in 60 healthy 2–3-year-olds (50% boys) aged 22 to 42 months. Of the 242 young children observed on the follow-up data collection, 33 were not compliant with wearing one or both devices and 149 had less than two hours of monitoring for both devices simultaneously, and were therefore, excluded from the current analyses.

The Get-Up! Study was approved by the University of

Results

Descriptive characteristics of the young participating are presented in (supplementary material - Table S2). Thirty boys and 30 girls were included. The majority of the sample was normal weight (93%). Regarding wear time, 2–3year-olds wore both devices, on average, for 4.1 h ± 1.2 h (range = 2.3 h–7.0 h).

The 95% Limits of agreement and respective Bland and Altman pots can be seen on Fig. 1.

Estimates of SB according to the different ActiGraph cut-points were not within the activPAL ±10% (Fig. 2)

Discussion

Although none of the hip-mounted ActiGraph cut-points used to define SB in 2–3-year-olds were equivalent to activPAL siting time, estimates of SB derived from the 48counts/15 s7 and 5counts/5 s8 cut-points overlapped the equivalence region and provided estimates with the smallest mean bias (∼5%). While the cut-points of 25counts/15 s, 37counts/15 s and 181counts/15 s also provided estimates of SB that overlapped the equivalence region derived from activPAL estimates, the mean bias from these

Conclusion

None of the ActiGraph hip-mounted cut-points provided estimates of SB in 2–3-year-olds that were equivalent to estimates of sitting time from the activPAL; however, estimates from the points slightly greater than (the best cut-point that underestimated) or slightly smaller than (the best cut-point that overestimated) are expected to provide group-level estimates of SB in 2–3-year-olds that are similar to estimates of sitting from the activPAL. Nevertheless, even the most accurate cut-point

Acknowledgements

João R. Pereira and Eduarda Sousa-Sá are supported by PhD scholarships from University of Wollongong. Zhiguang Zhang is supported by a PhD scholarship from China Scholarship Council. Rute Santos had a Discover Early Career Research Award from the Australian Research Council (DE150101921). No specific sources of funding were used to assist in the preparation of this article.

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